Clinical research of diversion colitis in patients after rectal cancer surgery

OUYANG Man-zhao, LIAO Tian-you, WU Jin-hao, ZHANG Wei-jie, LUO Zhen-tao, TANG Li, YAO Xue-qing

Chinese Journal of Clinical Anatomy ›› 2018, Vol. 36 ›› Issue (3) : 338-342.

Chinese Journal of Clinical Anatomy ›› 2018, Vol. 36 ›› Issue (3) : 338-342. DOI: 10.13418/j.issn.1001-165x.2018.03.021

Clinical research of diversion colitis in patients after rectal cancer surgery

  • OUYANG Man-zhao1, LIAO Tian-you1, WU Jin-hao1, ZHANG Wei-jie1, LUO Zhen-tao1, TANG Li1, YAO Xue-qing2
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Abstract

Objective To investigate the occurrence, clinical symptoms and colonoscopy characteristics of diversion colitis after rectal cancer, so as to improve the clinical understanding of it.  Methods The clinical symptoms and endoscopic data of 89 cases and 375 cases with or without protective ostomy after rectal cancer surgery were retrospectively analyzed. Results In the ostomy group, 30 cases showed the clinical symptoms of diversion colitis, and the incidences of abdominal pain, excreting mucus or mucous bloody stools were14.6%, 23.6% and 12.4% respectively, which were all higher than those without ostomy 2.9% 5.1% and 1.9% respectively (P<0.05). The positive rates of erythema swelling, erosion and ulcers, inflammatory follicular hyperplasia, inflammatory polyps and anastomotic stenosis in ostomy group were 93.3%,29.2%,15.7%,29.2%,15.7% respectively, significantly higher than those without ostomy (14.1%, 7.5%, 0.5%, 6.7% and 4.5% respectively). However, the absolute count of CD3+ (980±475) / μl, CD4+ (550±243) / μl, CD8+ (342±206) / μl, and CD4+ / CD8+ ratio (1.94±1.44) in ostomy group showed no statistical difference when compared with those without ostomy (P>0.05). Conclusion Diversion colitis has a high incidence in about 3 months after colorectal diversion. Endoscopy enables early clinical diagnosis of the disease for early symptomatic treatment.

Key words

Diversion colitis /  Rectal cancer /  Ileostomy /  Complication

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OUYANG Man-zhao, LIAO Tian-you, WU Jin-hao, ZHANG Wei-jie, LUO Zhen-tao, TANG Li, YAO Xue-qing. Clinical research of diversion colitis in patients after rectal cancer surgery[J]. Chinese Journal of Clinical Anatomy. 2018, 36(3): 338-342 https://doi.org/10.13418/j.issn.1001-165x.2018.03.021

References

[1] Glotzer DJ, Glick ME, Goldman H. Proctitis and colitis following diversion of the fecal stream[J]. Gastroenterology, 1981, 80(3):438-441.
[2] Whelan RL, Abramson D, Kim DS, et al. Diversion colitis. A prospective study[J]. Surg Endosc, 1994, 8(1):19-24.
[3] Ferguson CM, Siegel RJ. A prospective evaluation of diversion colitis[J]. Am Surg, 1991, 57(1):46-49.
[4] Ma CK, Gottlieb C, Haas PA. Diversion colitis: a clinicopathologic study of 21 cases[J]. Hum Pathol, 1990, 21(4):429-436.
[5]  Szczepkowski M, Kobus A, Borycka K. How to treat diversion colitis?--Current state of medical knowledge, own research and experience[J]. Acta Chirurgica Iugoslavica, 2008, 55(3):77-81.
[6] Bosshardt RT, Abel ME. Proctitis following fecal diversion[J]. Dis Colon Rectum, 1984,27(9):605-607.
[7] Roe A M, Warren BF, Brodribb AJ, et al. Diversion colitis and involution of the defunctioned anorectum[J]. Gut, 1993, 34(3):382-385.
[8]  Villanacci V, Talbot I C, Rossi E, et al. Ischaemia: a pathogenetic clue in diversion colitis?[J]. Colorectal Disease, 2007, 9(7): 601-605.
[9]  阙长榕, 许东波, 李军, 等. 直肠癌术后吻合口狭窄35例治疗分析[J]. 中华普通外科杂志, 2015, 30(12): 969-971.
[10]Yeong M L, Bethwaite P B, Prasad J, et al. Lymphoid follicular hyperplasia-a distinctive feature of diversion colitis[J]. Histopathology, 1991,19(1): 55-61.
[11]Kabir SI, Kabir SA, Richards R, et al. Pathophysiology, clinical presentation and management of diversion colitis: a review of current literature[J]. Int J Surg, 2014,12(10):1088-1092.
[12]姚学清,欧阳植安,林锋,等. 影响直肠癌全直肠系膜切除术预后因素[J]. 中国临床解剖学杂志, 2005, 23(5): 547-549.
[13] 严健, 原永明, 张舒, 等. CD3+、CD4+、CD8+T淋巴细胞亚群在肿瘤患者外周血中检测的临床意义[J].检验医学, 2013, 28(10): 901-903.

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